Premenstrual syndrome.

PMS is a constellation of symptoms, both somatic (breast tenderness, bloating, headache) and psychologic-behavioral (irritability, hostility, depression) that recur prior to the menses in about 5% to 20% of all menstruating women. Such women should be evaluated with a thorough history and physical examination, and if the diagnosis is firmly established by observing a temporal relationship of the symptoms with the premenstruum, therapy should be initiated. When treating PMS, reassurance should always be offered to the patient along with counseling regarding life-style and dietary changes. Symptomatic relief may be provided with any number of medications, including diuretics, NSAIDs, and possibly progesterone. Oral contraceptive therapy may also be helpful. Although patience is certainly required in order to deal with this often frustrating problem, it should be remembered that patient satisfaction is commonly within reach.